<div class="layuimini-container">
    <form id="app-form" class="layui-form layuimini-form">
                
        <div class="layui-form-item">
            <label class="layui-form-label">用户信息</label>
            <div class="layui-input-block">
                <div data-toggle="table-data" data-index="{:__url('user/index')}" data-select-type="radio" data-select-value="" data-value-field="id" data-name="user_id" data-field-name="user_nickname" data-required="1">

                </div>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">充值规则id</label>
            <div class="layui-input-block">
                <input type="text" name="charge_rule_id" class="layui-input"  placeholder="请输入充值规则id" value="0">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">订单编号</label>
            <div class="layui-input-block">
                <input type="text" name="order_sn" class="layui-input" lay-verify="required" placeholder="请输入订单编号" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">金额</label>
            <div class="layui-input-block">
                <input type="text" name="total_money" class="layui-input" lay-verify="required" placeholder="请输入金额" value="0.00">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">充值金额</label>
            <div class="layui-input-block">
                <input type="text" name="charge_money" class="layui-input" lay-verify="required" placeholder="请输入充值金额" value="0.00">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">支付状态</label>
            <div class="layui-input-block">
                {foreach $select_list_pay_status as $k=>$v}
                <input type="radio" name="pay_status" value="{$k}" title="{$v}" {in name="k" value="0"}checked=""{/in}>
                {/foreach}
            </div>
        </div>

        <div class="layui-form-item">
            <label class="layui-form-label">支付时间</label>
            <div class="layui-input-block">
                <input type="text" name="pay_time" class="layui-input"  placeholder="请输入支付时间" value="">
            </div>
        </div>
        <div class="hr-line"></div>
        <div class="layui-form-item text-center">
            <button type="submit" class="layui-btn layui-btn-normal layui-btn-sm" lay-submit>确认</button>
            <button type="reset" class="layui-btn layui-btn-primary layui-btn-sm">重置</button>
        </div>

    </form>
</div>